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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005273
Report Date: 08/25/2020
Date Signed: 09/03/2020 01:20:20 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LYCEE FRANCAIS DE SAN FRANCISCO (PS)FACILITY NUMBER:
214005273
ADMINISTRATOR:ELIANE STORME, DIRECTORFACILITY TYPE:
850
ADDRESS:100 EBBTIDE AVENUE, BUILDING 5TELEPHONE:
(415) 661-5232
CITY:SAUSALITOSTATE: CAZIP CODE:
94965
CAPACITY:83CENSUS: 0DATE:
08/25/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Elaine StormeTIME COMPLETED:
02:15 PM
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Licensing Program Analysts (LPAs) Adam Rodriguez and Haydee Caliboso met with the Director Elaine Storme for an announced case management inspection. The facility requested to add multi-purpose room classroom.

LPAs toured the proposed new classroom, which is set up for childcare. Existing areas on the licenses, indoor and outdoor, were observed to be clean, safe, and free from hazards. New classroom was measured and inspected today for health and safety hazards. Indoor space measures 731.07 square feet, allowing for a capacity of 20 children. See facility sketch and capacity worksheet in file. The requested additional classroom has a built-in kitchen counter-top with one sink and drawers for storage. There is a working refrigerator to store children’s food and a working microwave. The additional classroom has a bathroom with 2 toilets and 2 sinks inside the classroom. The bathroom is clean and with no health and safety hazards. All cleaning supplies, hazardous items are stored in a locked cabinet made inaccessible to children.

The following is required prior to approval:
  • Door chime inside the bathroom
  • Fire Clearance approved by Marin County

No deficiencies were observed today. Notice of site visit was observed to be posted and shall remain posted for 30 days.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R CalibosoTELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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